Strengthen Hips To Reduce Knee Pain

There are a few basic hip exercise that I prescribe to nearly everyone I train whether they are high performance athletes or first timers.  One of the first steps I take when starting with someone is an assessment of core, hip, and ankle stability and strength, and most people score low on most tests.  Indeed when I first learned of these tests over 15 years ago, I scored low on them myself.

Poor hip strength is linked to knee pain (2), and a variety of hip strengthening and movement corrective exercises will reduce or eliminate common knee pain and greatly improve athletic performance in foot speed, moving sideways, and producing power.

The trouble is some of these exercises are perceived as being tedious and unusual compared to standard strength training exercises, while the final stage of advanced exercises are hard to do both strength-wise and in terms of maintaining focus on retaining good form.  I've seen these factors result in many either dismissing the corrective exercises as too weird, taking too long to get results, or conversely many will do the rehab exercises at far too high of an intensity to be useful; overworking the person instead of gradually progressing them forward.

Within a couple months of hip and core strengthening mechanics can be corrected (3, 4) and knee pain can be greatly reduced, especially in woman, whose greater thigh bone angle and generally wider hips make them more susceptible to knee pain.

An Indiana University press release on June 3 (1), 2011 explains how stronger hips from a 2X per week (30 to 35 minutes) hip strengthening program improved running mechanics and lessened knee pain.  Click on the link below for more details.

Recently a 50 year old male athlete I've been working with won his age group in a short distance duathlon, the second duathlon he has ever entered. Paul Seier ran recreationally a few years ago but back, hip, and knee pain made the experience a literal pain in the butt.

Paul is also a competitive mountain biker, winning gold in the Manitoba Provincial Championships (2010) for his category (sport 40+ mens).

Part of what makes Paul's story compelling is that he's a regular guy with a family, runs a business with his wife, and has only so much time to exercise.  Also important to know about Paul, he previously suffered from chronic low back pain, reoccurring spasms in hip muscles, and knee pain.  All of these have been resolved through massage therapy (thanks Bryan!) and a long term progressive exercise program that incorporated the exercises referenced in the research article links below.

By following what research recommends to both reverse and prevent typical overuse injuries and pain due to poor mechanics and muscle weakness, Paul was able to enter duathlon races without any pain or suffering.  Paul reports that he can't believe how good he feels when he runs now; no pain, lot's of power, and no soreness afterwards.

It's true, your running can be pain free.  Do what Paul did, start with the basics, very gradually increase running (Paul started with only a few minutes of running once per week, and now runs on average 1 or 2 times per week, and rides his bike 1 or 2 times per week, and does basic hip strengthening exercises once per week).

A little goes a long way so long as you do it right and overcome two of the most difficult obstacles for increasing performance: the urge to exercise too hard too often, and the urge to follow traditional no-science based injury prone high-voulme, high-intensity exercise programs with no base conditioning.

Paul Seier- right, Cris LaBossiere- left

(1) ACSM: Stronger Hips Improved Running Mechanics, Lessened Knee Pain - ScienceNewsline

(2) Eccentric Hip Muscle Function in Females With and Without Patellofemoral Pain Syndrome

(3) A Proximal Strengthening Program Improves Pain, Function, and Biomechanics in Women With Patellofemoral Pain Syndrome

(4) The effect of real-time gait retraining on hip kinematics, pain and function in subjects with patellofemoral pain syndrome -- Noehren et al. -- British Journal of Sports Medicine

Obesity rates and life expectancy increase

Life expectancy has been increasing since about the 1400's when the average life expectancy was around 40 years.  Historically sanitation and medicine are two of the largest improvements that have increased human life span.

With medical advancements in treating cancer and other serious diseases, people are beating the odds or living longer with disease due to improvements in early detection and treatment regimens.

We've been hearing for the last two decades that we're becoming too overweight and out of shape, which will reduce our quality of life and ultimately shorten our lives.

It's true that being overweight and physically unfit increases your risk of developing illnesses that can reduce your life span, and it's true that every year more of the population is overweight and out of shape.

Despite this, life expectancy for the population as a whole continues to increase due to mostly to medical advancements, up to 2008.

For the first time since 1993, life expectancy in the US dropped by a couple months in the US, according to this press release from the CDC (average life expectancy was 77.8 in 2008 in the US):

CDC Media Relations - Press Release: December 9, 2010

In canada it looks like this:

So what does all this mean?  Not much to any individual.  Just a bunch of numbers. That's the problem with population averages; the average does not explain each individuals circumstances.  Those who smoke and drink daily and are overweight are less likely to see the endpoint of these life expectancy predictions or averages.

In reading reports on life expectancy I found that statisticians and medical researchers reported they don't always have precise explanations for fluctuations in trends. Some of the year to year changes are due to how data is collected and processed.  In general researchers are still predicting a drop in life expectancy if we continue to become more overweight and out of shape, but increases in medical care may offset this.

Being overweight as a population may compensate for the impact smoking had on our population; fewer people smoke now compared to the 40's through 60's so death rates due to smoking related illness is down, but more people are overweight so death rates due to complications from obesity are on the rise.

Let's make this practical.

Out of all I read on the subject here are the things that take years off your life:

• Smoking
• Excessive alcohol 
• Poor diet
• Being overweight or obese
• Physical inactivity
• Parents or grandparents died young from cancer or heart disease
• High stress
• Being bitter and angry most of the time
• Limited access to health care/ not getting regular medical check ups after age 40

Here are the things that add years to your life:

• Maintaining healthy body weight
• Daily exercise
• Good nutrition. Specifically, eating less
• Good sleep
• Low stress
• Having a positive outlook
• Close friends and family
• Access to healthcare over entire life

For smokers, the most significant improvement to health and life expectancy comes from quitting smoking.

An important detail; the last 20 years of your life are much higher quality, retaining a higher level of physical mobility, cognition, and fewer health complications, when you do the things in the second list.

That sounds pretty good!  Live healthy, and love it :-)

Exercise Builds Bone Density In Older Men

A study comparing the effects of vitamin D and calcium fortified milk with or without exercise, and exercise alone, showed that exercise provided a bone mineral density increase, but the fortified milk alone did not increase bone mineral density.

The study was done on men aged 50-79

Osteoporosis Canada recommends that adults over age 50 should have 1200mg/ day calcium, and 800 to 2000 IU/ day of vitamin D.

Meeting the daily vitamin and mineral requirement is essential, but exercise, specifically weight bearing exercise like jogging or weight training, is also critical.

It's important to note that the study protocol used a progressive resistance training model, meaning that the subjects gradually increased the loads they lifted as they became stronger.  Staying with light weights doesn't cut it.  Impact exercise like jogging and jumping are also potent bone builders, but like all exercise, more intensive activities should be added only as overall strength and physical ability increases.

Jack LaLanne Dies at Age 96

"Anything in life is possible, if YOU make it happen!" - Jack LaLanne

That quote was posted in memorandum on Jack LaLannes blog today.

He died of respiratory failure due to pneumonia.

LaLanne opened his own health club in Oakland, CA in 1936, and had a successful fitness show that ran in the 1950's.

Check out this guy's list of achievements.. Fantastic!

Jack LaLanne was relentless in his positive attitude and message of how living healthy makes you feel good and live longer, and showed us all how it's done.

LaLanne will be missed, but he created a legacy message.

For me, Jacks message is summarized best in his one liner "LaLannisms"

I've copied these from his website

• Anything in life is possible if you make it happen.
• Anything in life is possible and you can make it happen.
• Your waistline is your lifeline.
• Exercise is King, nutrition is Queen, put them together and you’ve got a kingdom.
• Don’t exceed the feed limit.
• The food you eat today is walking and talking tomorrow.
• Ten seconds on the lips and a lifetime on the hips.
• Better to wear out than rust out
• Do – don’t stew.
• People don’t die of old age, they die of inactivity.
• First we inspire them, then we perspire them.
• You eat everyday, you sleep everyday, and your body was made to exercise everyday.
• Work at living and you don’t have to die tomorrow.
• I can’t die, it would ruin my image.
• If man makes it, don’t eat it.
• If it tastes good, spit it out.
• What’s it doing for me?
• Your health account is like your bank account: The more you put in, the more you can take out.
• If one apple is good, you wouldn’t eat 100.
• It’s not what you do some of the time that counts, it’s what you do all of the time that counts.
• Make haste slowly.
• Eat right and you can’t go wrong.

Physical Exercise Prevents Cellular Senescence in Circulating Leukocytes and in the Vessel Wall -- Werner et al. 120 (24): 2438 -- Circulation

Physical Exercise Prevents Cellular Senescence in Circulating Leukocytes and in the Vessel Wall -- Werner et al. 120 (24): 2438 -- Circulation

Exercise and live longer?

It's a genetic fact. A recent study further confirms what previous research has shown; exercise affects cells and DNA structure increasing function and lifespan.

An important structure of DNA called a telomere dictates how many times a cell can make copies of it's self. Once you reach the telomere section of your DNA you are literally at the end of your rope. A length of DNA can make copies of it's self but each copy made uses up some of it's length. Telomeres are like end caps and when DNA has used up it's length and gets to the telomere it stops dividing.  The length of the telomere matters too: longer increases number of possible copies; shorter decreases number.

Exercise increases the length of the telomere allowing the DNA to keep making copies. The affect isn't indefinite; research has shown that exercise in sufficient volume and intensity can increase life span by over 10 years while smoking and obesity can shorten telomere length subtracting 10 years from normal life expectancy.

This research compared life long masters athletes (ave age 51) and younger pro athletes (ave age 20) and compared them to healthy non exercisers who did not smoke.

The athletes were significantly more fit (no kidding), had lower BMI, lower resting heart rate, and better cholesterol numbers. When the masters athletes were compared to the sedentary group it was found the athletes had lower telomere loss.

The masters athletes had exercised for decades with an average week having 80 kilometers per week of running.

This doesn't mean everyone should start running 80 km/ week, but it does show that people in their 50's who have been regular exercises have a distinct genetic advantage over their sedentary peers. The best thing about this genetic advantage is that you can make it yourself.

How do we make practical use of research looking at how our behavior affects telomere length?

Stay away from excessive sugar intake

Ditch the smokes or don't start smoking

Achieve and maintain a healthy weight

Exercise regularly